S.Amdt. 4688

The Keeping Obstetrics Local Act is an amendment designed to prevent the closure of obstetric units and improve maternal health care access, particularly in rural and safety-net hospitals. Its primary purpose is to ensure that hospitals can afford to keep their labor and delivery services open while expanding health coverage and support for pregnant and postpartum individuals.

The amendment aims to change and add the following to the bill:

Financial Support for Hospitals

• Requires Medicaid to provide adequate payment rates for maternity, labor, and delivery services at eligible hospitals.
• Increases Federal financial participation (FMAP) for these services.
• Establishes anchor payments to provide a revenue floor for low-volume obstetric hospitals to ensure they can maintain necessary personnel and equipment.
• Mandates State studies and HHS reports to analyze the actual costs of providing these services.

Expanded Maternal Health Coverage

• Mandates 12-month continuous, full benefit coverage for pregnant individuals under Medicaid and CHIP.
• Creates an option for maternity health homes to provide coordinated care for pregnant and postpartum women.
• Requires presumptive eligibility for pregnant individuals.
• Increases financial support for depression and anxiety screening during perinatal and postpartum periods.
• Directs the Secretary to provide guidance on covering services from doulas and maternal health professionals.

Workforce and Data Accountability

• Provides emergency obstetric workforce support by allowing the deployment of the Commissioned Corps for "urgent maternal health care needs."
• Streamlines the enrollment of out-of-state providers in neighboring states.
• Requires hospitals to give 180-day notice before closing an obstetric unit, including a report on the community impact.
• Mandates the collection and public reporting of data regarding hospital labor and delivery services, including expenses and revenue sources.